Rates of cervical cancer are higher than previously thought among African American and 65- to 69-year-old women in general, according to a study published online in May in the journal Cancer and led by a researcher at the University of Maryland School of Medicine in Baltimore. The study’s results drew particular attention because current guidelines do not recommend Pap smears to screen for cervical cancer in women older than age 65 if they've previously had normal test results.
“The higher rates of cervical cancer after correction for hysterectomy highlight the fact that, although a large proportion of cervical cancer has been prevented through early detection and treatment, it remains a significant problem,” the authors wrote. Previous estimates that did not correct for hysterectomies probably not only underestimated the true incidence of cervical cancer, but also likely resulted in “misleading race and age-specific comparisons,” the study authors concluded. Additionally, because the human papillomavirus (HPV) is believed to cause virtually all cases of cervical cancer, the researchers emphasized that HPV vaccination is imperative to limit the spread of the virus.
Incidence of cervical cancer was 27.4 cases per 100,000 women age 65-69 in the study—which was 84% higher than calculations for the uncorrected rate of 14.8 cases per 100,000 women. White women in that age range had a rate of 24.7 per 100,000 cases, and African American women in the same age group had 53 cases per 100,000. “In fact, African-American women had higher cancer rates at nearly all ages compared with white women, and the disparity was more pronounced at older ages, likely attributable to African-American women reporting a higher prevalence of hysterectomy than white women,” the University of Maryland School of Medicine said in a statement.
“Our corrected calculations show that women just past [age] 65, when current guidelines state that screenings can stop for many women, have the highest rate of cervical cancer,” lead author Anne F. Rositch, PhD, MSPH, assistant professor of epidemiology and public health at the University of Maryland School of Medicine, said in a statement. “It will be important to consider these findings when reevaluating risk and screening guidelines for cervical cancer in older women and the appropriate age to stop screening.”
Additionally, “it will be important to clarify in future studies whether the continued increase in cervical cancer rates with age and the higher rates in African-American women represent a failure in our screening programs or a failure of the women to be screened so that appropriate interventions can be applied,” Rositch said in the statement.